Early Term Delivery Versus Expectant Management of the Large for Gestational Age Fetus

Inclusion Criteria: * Singleton pregnancy * Plan for vaginal delivery. Patients with prior cesarean section are eligible if they are planning for a trial of labor after cesarean section. * Gestational age 34 weeks 0 days to 37 weeks 0 days at time of enrollment * Dating of pregnancy by last menstrual period consistent with an ultrasound, ultrasound \<21 weeks and 6 days of gestation, or known date of conception in the setting of in vitro fertilization * No known major anomalies (anomalies requiring surgery antenatally or in the neonatal period, anomalies not compatible with life as determined by the physician) * LGA defined as estimated fetal weight (EFW) \> 90th percentile by Hadlock formula but \<4500 grams Exclusion Criteria: * Pre-gestational diabetes or gestational diabetes on medication (oral or insulin, excluding metformin) * Planned cesarean delivery * Polyhydramnios * Known major fetal anomalies * Multiple gestation or selective reduction of multiple gestation after 14 weeks * Previous stillbirth at term * Indications for delivery at \<39 weeks. Common examples include: * Placenta previa * Placenta accreta * Vasa previa * History of classical cesarean section or myomectomy * Human immunodeficiency virus (HIV) * Oligohydramnios (low amniotic fluid, defined as maximum vertical pocket \<2.0cm) * High-risk pregnancy as determined by the physician. Common examples include: * Pre-gestational diabetes or gestational diabetes on medication * Chronic hypertension on medication * Maternal cardiac disease * Asthma requiring oral steroids during pregnancy * Chronic renal disease * Antiphospholipid syndrome * Hyperthyroidism * Prior stillbirth * Systemic lupus erythematous * Hemoglobinopathies such as sickle cell disease